Assignment: Common Discomforts Worksheet/Learning Template
Assignment: Common Discomforts Worksheet/Learning Template
Trimester: First
Name of common discomfort: Urinary frequency
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| Information you should gather for this discomfort | Guidance about how to focus your study | Is this information included in Common Discomforts Exams? | FILL IN YOUR RESPONSES HERE |
Brief physiologic cause (for clinicians’ understanding)  Struggling to meet your deadline ?Get assistance on Assignment: Common Discomforts Worksheet/Learning Template done on time by medical experts. Don’t wait – ORDER NOW!
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What is the physiology that we as clinicians must understand to investigate and manage this discomfort? | No, this part is not included in the Common Discomforts Exams. | Urinary frequency occurs due to the pressure of the growing uterus on the bladder.
This is characterized by frequency of micturition without pain or burning, and occurs before the 12th week. Progesterone relaxes the muscles of the urethra and may cause incontinence, while an increase in the glomerular filtration rate causes increased urine production (Kazma et al., 2020). |
| Brief physiologic cause (for patients’ understanding)
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What explanation should you provide, in patient-centered, non-medical language? | Yes, this part is included in the Common Discomforts Exams. | I understand your concern with the increased frequency in passing urine. This is a common discomfort in pregnancy. In early pregnancy, urinary frequency is caused by pressure exerted by the enlarging uterus on the bladder.
However, during the second trimester, the bladder pressure will lessen once the uterus becomes an abdominal organ (Kazma et al., 2020). |
| Focused history of present illness (HPI) elements
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What are the most important subjective/history factors that indicate normalcy?
Rather than a list of questions you WOULD ask, focus on the HPI FINDINGS that would RULE IN a normal concern of pregnancy and are reassuringly supportive that this is the identified common discomfort, rather than something more serious. |
Yes, this part is included in the Common Discomforts Exams. | The urinary frequency began about four weeks ago.
No burning sensation when passing urine or sensation of bladder fullness (Uzelpasaci et al., 2021). No painful urination. No fever, chills, or malaise. No blood in urine, cloudy urine, or urine with an abnormal color. No pelvic pain. No vulvar itchiness.
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| Chart review elements | What data in the chart would be reassuringly supportive that this is the identified common discomfort, rather than something more serious?
Chart review elements are already-completed labs and imaging results, history elements recorded in the chart from previous visits, and patient visit notes from past visits.
Chart review does NOT mean reviewing information from the current visit. For example, reviewing the blood pressure that a medical assistant recorded for the current visit before you see the patient is NOT chart review. |
Yes, this part is included in the Common Discomforts Exams. | No history of urinary frequency or urinary tract infections in the pre-pregnancy period.
No history of urinary symptoms. No history of stress urinary incontinence or kidney stones (Gonzalez Suarez et al., 2019). No history of STIs. Urinalysis- no abnormal findings. Urine culture- no signs of bacteria or yeast (Gonzalez Suarez et al., 2019). |
| Focused objective data, including physical exam, imaging, labs
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Do you need objective data to determine normalcy?
If so, what are the most important objective factors that indicate normalcy?
Include focused, prioritized, and reasonable physical exam elements, imaging studies, and labs.
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Yes, in the Common Discomforts Exams, you will need to indicate whether objective data are needed, assuming that all HPI and chart review elements are benign. | No physical exam, imaging, or lab tests will be needed since you have no signs of bladder infection like painful urination, burning with voiding, or blood in the urine.
Objective factors that indicate normalcy are: · No costovertabral tenderness. · No lower abdominal tenderness. · No fever. |
| Assessment/differentials
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NORMAL common discomfort of pregnancy should be a top differential.
Then, what are the other diagnoses/conditions that COULD be responsible for the clinical picture? |
No, this part is not specifically included in the Common Discomforts Exams. | Ø Urinary frequency in the first trimester.
Other differentials: · Urinary tract infection in pregnancy · Bladder Dysfunction · Glomerulonephritis (Gonzalez Suarez et al., 2019). · Chlamydial Genitourinary Infections · Nonbacterial and Noninfectious Cystitis |
| Education
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What prioritized education should you share with your patient and their family, including treatments, relief strategies, danger signs, or anything else(after eliciting their needs and values)? | Yes, treatments and relief strategiesare included in the Common Discomforts Exams. | Void when urge is felt.
Increase fluid intake during the day (Uzelpasaci et al., 2021). Decrease fluid intake only in the evening to decrease nocturia. Kegel exercises to help maintain the bladder. Use of panty liners in case of urine leaks (Uzelpasaci et al., 2021). |
| Health care teamwork | When and with whom should you consult, collaborate, or refer?
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No, this part is not specifically included in the Common Discomforts Exams. | Consult with obstetrician if the patient develops signs of UTI or recurrent UTIs in pregnancy. |
| Follow-up
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Is there any other follow-up that might be useful? When and how would that happen? | No, this part is not specifically included in the Common Discomforts Exams. | Advise the woman to seek medical help if she experiences painful urination, burning with voiding, or blood in the urine (Uzelpasaci et al., 2021). |
References
Gonzalez Suarez, M. L., Kattah, A., Grande, J. P., & Garovic, V. (2019). Renal Disorders in Pregnancy: Core Curriculum 2019. American journal of kidney diseases : the official journal of the National Kidney Foundation, 73(1), 119–130. https://doi.org/10.1053/j.ajkd.2018.06.006
Kazma, J. M., van den Anker, J., Allegaert, K., Dallmann, A., & Ahmadzia, H. K. (2020). Anatomical and physiological alterations of pregnancy. Journal of pharmacokinetics and pharmacodynamics, 47(4), 271–285. https://doi.org/10.1007/s10928-020-09677-1
Uzelpasaci, E., Çinar, G. N., Baran, E., Gürşen, C., Nakip, G., Ozgul, S., Beksac, K., Unal, C., Orgul, G., Beksac, A. T., Akbayrak, T., & Beksac, M. S. (2021). Trimester-based changes in urogenital symptoms and their impact on the quality of life in pregnant women: A preliminary report. Current urology, 15(3), 167–171. https://doi.org/10.1097/CU9.0000000000000021
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